A pleural effusion is fluid collecting in the chest cavity. This can be due to a number or causes such as infection, inflammation and sometimes cancer. A significant fluid collection can lead to symptoms of shortness of breath.

Pleural effusions can be drained but it is best if we can help determine and treat any underlying cause. As such, you may be referred initially for a biopsy. The good news is that the biopsy and treatment can be done in one operation, a sample of tissue if sent for analysis and the pathologist can call the theatres to report the sample whilst you are still under anaesthesia, and we can proceed to treatment.

Sometimes, an answer is not always obtainable and we would need to plan what to do if that is the case. There are two options, the first is that we stop, wait and see if the effusion comes back, and the second is that we proceed to treatment anyway. If we proceed to treatment without a diagnosis it can be difficult to go back into the chest in future if further biopsies are required.

Treatment can be done in a number of ways, currently the two most common choices are putting powder (talc) into the chest cavity to cause scar tissue formation, but this is only suitable if the lung re-expands sufficiently to touch the chest wall as we can only stick surfaces together that are in contact. Sometimes when the lung is squashed by the fluid over a long period of time, it does not expand even after the fluid is removed. In this case, we would place a small flexible drain designed to remain in your chest over a long period to allow you to drain the fluid regularly.

There are always choices and options, so have a think which suits your best, I would be happy for you to contact me to discuss.